by Lucy Barnes
July 3, 2002
QUESTION: What is Lyme disease and who is at risk?
ANSWER: Lyme Disease is caused by a bacteria known as a spirochete (similar to the one that causes syphilis) and can be found in at least nine different species of ticks, six species of mosquitoes, 13 species of mites, 15 species of flies, two species of fleas, and numerous wild and domestic mammals including rabbits, rodents, and birds. Once transmitted to humans, the spirochete causes damage by spreading to various parts of the body. It can infect any and all organs and tissues in the body, causing a multitude of symptoms that can make a person very ill. It is often disabling and occasionally fatal.
Q: Can it be transmitted from person to person?
A: The spirochete that causes Lyme disease has been found in semen, urine, blood, breast milk, and other body fluids and tissues. Those who have Lyme disease are prohibited from donating blood or organs. Lyme disease has also been shown in many cases to be passed from mothers to their unborn children and to babies through breast milk. The spirochete can be found in the blood of deer, which poses a threat to hunters; it is therefore recommended that anyone handling raw venison use gloves.
Q: What are some of the signs and symptoms of the disease and its effects?
A: Unless a doctor is very experienced with Lyme disease, they may not recognize it until it is too late, if they detect it at all. Lyme Disease has been misdiagnosed as a variety of other conditions, including multiple sclerosis, chronic fatigue, Alzheimer's, fibromyalgia, depression, lupus, ADD, and various forms of arthritis. The list of possible symptoms is overwhelming. Everything from hearing loss to panic attacks which surface in otherwise healthy individuals can be the first indication that a person has contracted Lyme Disease. Some patients do not recall a tick bite (the most common form of transmission) and many never get the typical bulls-eye rash or flu-like symptoms that are associated with early stages of the disease.
Lyme Disease can increase eye light sensitivity and cause floaters, conjunctivitis, unequal pupils, bacterial infections, optic neuritis, blurred or double vision, and even blindness. The brain and surrounding tissues may become infected, leaving the patient with permanent damage and/or pain. Cranial nerve palsies, encephalopathy, meningitis, dementia, irreversible intellectual impairment, memory deficits, brain hemorrhages, intracranial pressure, and aseptic meningitis can also result. A number of people, especially children, have problems with their digestive tract, and people with Lyme can battle acid reflux, diarrhea, partial to full intestinal blockages, and pain. The bladder and reproductive organs are also affected--women may experience menstrual difficulties, while swollen testicles and pelvic pain may cause problems for men. Patients often experience brain "fog," memory problems, confusion, and difficulties with speech and thought processes. Extreme fatigue can be a constant problem, along with muscle spasms and joint pain.
Consequent heart and lung difficulties can range from palpitations and shortness of breath to heart attack and respiratory failure. Depression, severe anxiety, insomnia, and mood swings are very common. The list goes on and on. It is best to consider Lyme Disease as a possible ailment when a patient is experiencing "bizzare" or seemingly unrelated symptoms, or if the affliction does not respond to "standard" treatment. Lyme disease can be contracted very unexpectedly--the blood tests used to detect Lyme antibodies are missing approximately half of the new cases of Lyme Disease. Lyme, according to the Center for Disease Control, is a "clinical diagnosis," and negative tests should NOT rule out the disease.
Q: Can it cause other diseases?
A: Lyme can mimic many diseases and can force the patient to receive treatment for a variety of other problems. Thyroid responses can be thrown off and require adjunct therapy. Other infections (such as bladder, sinus, eye, and kidney infections) often develop and are hard to fight off once the immune system is compromised. As the spirochetes inhabit and die off in the human body, toxins develop, which, unless properly treated, can cause a multitude of chronic problems.
Q: If caught early, can the effects be minimized?
A: Outdated information indicates that a tick must be attached for at least 24 to 48 hours to infect a person. This is not the case. If you are bitten by a tick, the old wait-and-see approach can be devastating. You should NOT wait for blood test results and rashes or symptoms to appear--it is best that treatment be received as early as possible.
Q: What type of treatment is available and how long does it run?
A: Treatment protocols vary depending on the time lapse between infection and treatment. Current guidelines indicate that newly-discovered tick bites and early cases should be treated with antibiotics for a minimum of four to six weeks. Cases of disease in late stages usually require a minimum of four to six months of treatment, through either IV or oral medications or both. If treatment is discontinued before all symptoms of Lyme disease have ended, the person can remain ill and relapse. Many patients who are not treated properly develop chronic cases of the disease and often need ongoing treatment to prevent rapid deterioration of their health.
Q: What are the long-term effects of Lyme disease?
A: Patients can relapse with any and all of the original symptoms, develop new ones, and progressively deteriorate as time goes by. Lyme disease can affect one's ability to walk by limiting range of motion. Difficulties with speech, writing, and communication may worsen. Many patients become bedridden. The financial burden of Lyme disease can also be very problematic. Many insurance companies even continue to deny the necessity of treatment for Lyme, which further stresses individuals and worsens their condition.
Q: What is the risk of contracting Lyme disease in Maryland?
A: Maryland's mild winters allow for year-round exposure to ticks and other insects carrying Lyme disease. One female tick can produce 2,000 to 5,000 offspring. An area may begin with a relatively small number of ticks; however, tick populations always increase rapidly. They are carried into new areas by pets, birds and other wildlife, and people.
Q: What are some preventative measures that people can take to stay healthy?
A: It is difficult to wear long pants, long sleeved shirts, socks, shoes, and a hat outdoors during Maryland summers. Since it may not be possible to stay completely covered and protected, I recommend regular tick checks while outdoors and again after returning home. Showering using a stiff washcloth may help to dislodge ticks before they become fully attached to the skin. I also recommend that Repel Permanone be applied to outdoor clothing, hats, duffel bags, and equipment. This product kills ticks as they crawl across treated surfaces. Yards can be treated with Sevin (dust or liquid form), available locally in the garden department of many stores. It won't kill all of the ticks, but it will reduce the numbers to a safer level.
Q: What other tick-borne diseases are found in Maryland?
A: There are an increasing number of patients who contract Babesia, Bartonella (or cat scratch fever), Rocky Mountain Spotted Fever, and Ehrlichiosis individually or as co-infections along with Lyme Disease. These may appear with or without typical symptoms and are often overlooked during diagnosis. All of these diseases can become chronic or even prove fatal if left untreated.
Barnes writes from Church Hill, MD.
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This story was published on July 3, 2002.